J.Jpn. Surg. Soc.. 82(9): 968-972, 1981

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Report on the annual meeting

BRONCHOPLASTIC PROCEDURES FOR LUNG CANCER AND THE RESULTS

Forty five patients with lung cancer have undergone bronchoplastic procedures from September, 1965 to December, 1980 in the National Cancer Center Hospital. There were 43 men and 2 women, varying in age from 33 to 74 years. Twenty were in the sixth and 6 in the seventh decades. The post-surgical stages of disease were as follows: 4 cases of Stage I disease, 7 cases of Stage II disease, 30 cases of Stage III disease and 4 cases of Stage IV carcinoma. Various bronchoplastic procedures have been done, including 27 for right upper lobe lesion and 11 for those involving the bronchus of left upper lobe. Six cases had sleeve lobectomy combined with pulmonary artery resection. Adjuvant therapy was performed on 34 cases, including preoprative infusion of mitomycin C into the bronchial arteries or postoperative irradiation or both. Postoperative stenosis ocurred in 5 cases becuase of granulation at the site of anastomosis. One patients required pneumonectomy. Twenty-two of 45 patients are alive and well from 1 month to 15 years after this operation. The relative 5 year survival rates are 42.5% of total cases and 50.4% of squamous cell carcinomas.
Bronchoplastic procedures are considered to be indicated for early cases of hilar lung cancer rather than for somewhat advanced cases. Endoscopic examination and roentgenograms of the bronchial arteries are needed to delineate resectional lines of bronchus, the former for deciding the mucosal extent and the latter the intrabronchial extent of the tumor. The bronchoplastic procedures we adopted were free from the risks and dangers generally accompanying the operation, and there were no postoperative deaths. For the prevention of postoperative complications, careful attention to suture technique is needed, and postoperative bronchoscopic suction of intrabronchial secretions is absolutely necessary. The use of polyglycolic acid suture showed good postoperative course. These procedures assure good quality of life postoperatively and improvement in the survival rate by preserving pulmonary function, enhancing curability, and increasing the operative indications. These advantages warrant high evaluation of the operation.

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